ICD-11 . . . What Does the NCVHS Full Committee Analysis Tell Us?

Gloryanne Bryant, RHIA, CDIP, CCS, CCDS Medical Coding Leave a Comment

ICD-11 . . . What Does the NCVHS Full Committee Analysis Tell Us?

Have you noticed that we are reading and hearing more and more about ICD-11? Looking back over the past few years we see that in June 2018 the World Health Organization (WHO) published (released) ICD-11 for review and the World Health Assembly formally adopted this version on May 25, 2019 to be effective beginning January 1, 2022. In fact, WHO has a home page dedicated to ICD-11, so check that out; ICD-11 (who.int)

The United States (U.S.) National Committee on Vital and Health Statistics (NCVHS) held a Subcommittee on Standards with an ICD-11 Expert Roundtable Meeting in August 2019. The objectives of this meeting were the following:

  • Develop a shared understanding of lessons from the ICD-10 planning process/transition and the differences between ICD-10 and ICD-11.
  • Reach consensus on the research questions to be answered to inform evaluation of cost and benefit of transition from ICD-10 to ICD-11 for mortality and morbidity – and to identify impacts of not moving to ICD-11 for morbidity.
  • Identify key topics/messages to communicate to the industry to foster early stakeholder engagement and preparation for the transition to ICD-11.

Use the following link to access the meeting information: Subcommittee on Standards – ICD-11 Evaluation Expert Roundtable Meeting – National Committee on Vital and Health Statistics (hhs.gov)

This was followed by a written recommendation from the NCVHS to the Secretary of Health and Human Services (HHS) regarding, “Preparing for Adoption of ICD-11 as a Mandated U.S. Health Data Standard” in November 2019. See: Recommendation Letter-Preparing for Adoption of ICD-11 as a Mandated US Health Data Standard (hhs.gov)

In February 2020, AHIMA Senior Director, Coding Policy and Compliance, Sue Bowman, MJ, RHIA, CCS, FAHIMA wrote an article in the AHIMA Journal regarding the need for HHS to be proactive toward adoption and implementation of ICD-11. See: NCVHS Recommends Government Actions to Prepare for US Adoption of ICD-11 | Journal Of AHIMA

That brings us to the recent NCVHS full committee meeting to discuss a comparative analysis of ICD-10 with ICD-11 held on March 20, 2021. Three members from the National Library of Medicine, National Institutes of Health participated in the analysis presentation; Kin-Wah Fung, Julia Xu, and Olivier Bodenreider, along with two members of the National Center for Health Statistics, Centers for Disease Control and Prevention; Donna Pickett and Shannon McConnell-Lamptey. The presentation summarizes that of 943 frequently used ICD-10-CM codes, that represent 60% of usage from each chapter, ICD-11 can achieve:

  • 5% full representation without postcoordination
  • 6% full representation with postcoordination (can be increased to 35.2% with minor enhancements)
  • 9% partial representation

This important analysis tells us that we should be proactive rather than reactive to ICD-11. You can view the comparative analysis at: https://ncvhs.hhs.gov/wp-content/uploads/2021/04/I-ICD-Kin-Wah-508.pdf

For those us in HIM, we need to direct our attention to ICD-11 and read up on the ICD-11 classification system changes it will bring. In addition, keep a watch on the U.S. approval process and ultimate implementation date. Although it may be a few years off, we can expect that mortality data using ICD-11 will come first. Whether it’s ICD-10-CM/PCS or ICD-11 obtaining and maintaining knowledge and skills for accurate coding always matters.

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